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Case report

ALTERED PAIN PERCEPTION IN SELF-INJURIOUS BEHAVIOR AND THE ASSOCIATION OF PSYCHOLOGICAL ELEMENTS WITH PAIN PERCEPTION MEASURES: A SYSTEMATIC REVIEW

Teja Bunderla
Hojka Gregorič Kumperščak


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Abstract

Background: The pathophysiology of non-suicidal self-injury (NSSI) is controversial. There is growing evidence of altered pain
perception in people engaging in NSSI. Some hypotheses have been made on addictive aspects of this behavior. Pain and addictive
behavior are modulated by the opioid system, which makes the endogenous opioids one of the candidate neurotransmitters related to
NSSI. This article explains the theoretical background on NSSI as an addictive behavior, endogenous opioids involvement and pain
perception changes in NSSI and updates the latest findings in this field. The main aim of this paper is a comprehensive review of
published studies on pain perception in NSSI and an evaluation of the impact of NSSI functions and other psychological elements on
pain perception measures.
Subjects and methods: We have reviewed six studies of pain perception in participants with NSSI compared with controls. The
participants of these studies were not mentally disabled or autistic and did not have a diagnosed personality disorder.
Results: The reviewed studies have demonstrated a higher pain threshold and longer pain tolerance or endurance in five of six
studies. Emotional dysregulation was significantly associated with all pain perception variables in one study. Neuroticism, selfcriticism
and painful and provocative experiences revealed correlated with pain endurance or pain tolerance. No correlation
between pain perception measures and dissociation, hopelessness or locus of control was found.
Conclusions: Pain perception was altered in participants with NSSI. Pain perception was associated to emotional dysregulation,
self-criticism, neuroticism and painful and provocative experiences. Because of the small number of studies reviewed, results should
be seen as guidelines for further studies. They should be replicated on a bigger sample of studies. Further research should focus on
pain perception measures in participants with NSSI and an excluded personality disorder.

Keywords

self-injurious behavior - NSSI - deliberate self-harm - pain perception - nociception – receptors - opioid

Hrčak ID:

162532

URI

https://hrcak.srce.hr/162532

Publication date:

15.12.2015.

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